Overview of Pilot

The Medicare Pilot Program for Asbestos Related Disease is an innovative new program for certain people with Medicare in Lincoln and Flathead County in Montana. The program provides comprehensive, coordinated, and cost-effective care, including services not normally covered under Medicare. Beneficiaries who enroll in this pilot program will be able to work with a nurse case manager to help get the care needed.

Noridian is running this program for Medicare effective for services provided on or after July 1, 2011.

Libby, Montana is the site of a public health emergency caused by airborne pollutants from a vermiculite mine in the 1920s to the 1990s. People who developed certain medical conditions as a result of exposure to this health hazard are eligible for Medicare under the Affordable Care Act’s “Exposure to Environmental Health Hazards” provision.

Initially, benefits and services of the Medicare Pilot Program for Asbestos Related Disease were limited to residents residing in Lincoln and Flathead Counties. In March 2014, the Pilot Program expanded to include coverage of additional beneficiaries and geographic areas. Benefits are applicable for beneficiaries who lived in Lincoln, Flathead, or the expansion counties between July 1, 2011 and March 1, 2014, but subsequently moved out of the area. These individuals will be permitted to enroll into the Pilot until March 1, 2015. These beneficiaries will be required to show proof of having lived in the Pilot service area (including the expansion counties). The Following is a list of the expanded geographic areas for the program.

Montana

Washington

Idaho

Glacier

Ferry

Benewah

Lake

Lincoln

Bonner

Mineral

Pend Oreille

Boundary

Missoula

Spokane

Clearwater

Sanders

Stevens

Kootenai

Lincoln (Current coverage)

Whitman

Latah

Flathead (Current coverage)

Shoshone

Along with meeting residency requirements, these following requirements must also be met: